Infliximab for Crohn's disease in the Swiss IBD Cohort Study: clinical management and appropriateness

Antitumor necrosis factor a agents have significantly improved the management of Crohn's disease (CD), but not all patients benefit from this therapy. We used data from the Swiss Inflammatory Bowel Disease Cohort Study and predefined appropriateness criteria to examine the appropriateness of use of infliximab (IFX) in CD patients.

Appropriateness of therapy for fistulizing Crohn's disease: findings from a national inflammatory bowel disease cohort

About 30-50% of patients with Crohn's disease (CD) develop fistulae, implying significant disease burden and complicated clinical management.

Appropriateness of reporting statistical results in orthodontics: the dominance of P values over confidence intervals

The purpose of this study was to search the orthodontic literature and determine the frequency of reporting of confidence intervals (CIs) in orthodontic journals with an impact factor. The six latest issues of the American Journal of Orthodontics and Dentofacial Orthopedics, the European Journal of Orthodontics, and the Angle Orthodontist were hand searched and the reporting of CIs, P values, and implementation of univariate or multivariate statistical analyses were recorded. Additionally, studies were classified according to the type/design as cross-sectional, case-control, cohort, and clinical trials, and according to the subject of the study as growth/genetics, behaviour/psychology, diagnosis/treatment, and biomaterials/biomechanics. The data were analyzed using descriptive statistics followed by univariate examination of statistical associations, logistic regression, and multivariate modelling. CI reporting was very limited and was recorded in only 6 per cent of the included published studies. CI reporting was independent of journal, study area, and design. Studies that used multivariate statistical analyses had a higher probability of reporting CIs compared with those using univariate statistical analyses. Misunderstanding of the use of P values and CIs may have important implications in implementation of research findings in clinical practice.

Impact of Various Insurance Types on Level and Appropriateness of Health Care Consumption

The goal of this study was to examine the extent to which insurance type, or method of care management, impact the appropriate delivery of health care. Previous studies indicate a relationship between insurance type and patterns of consumption but do not directly link the incentives or disincentives inherent in each plan with trends inconsumption of health care. This study explores how different types of health insurance coverage affect the location, the degree, and the frequency of health care consumption in order to gain insight into which plans promote appropriate delivery and consumption ofcare.

Appropriateness and long-term discontinuation rate of biological therapies in ulcerative colitis

BACKGROUND Anti-TNFα agents are commonly used for ulcerative colitis (UC) therapy in the event of non-response to conventional strategies or as colon-salvaging therapy. The objectives were to assess the appropriateness of biological therapies for UC patients and to study treatment discontinuation over time, according to appropriateness of treatment, as a measure of outcome. METHODS We selected adult ulcerative colitis patients from the Swiss IBD cohort who had been treated with anti-TNFα agents. Appropriateness of the first-line anti-TNFα treatment was assessed using detailed criteria developed during the European Panel on the Appropriateness of Therapy for UC. Treatment discontinuation as an outcome was assessed for categories of appropriateness. RESULTS Appropriateness of the first-line biological treatment was determined in 186 UC patients. For 64% of them, this treatment was considered appropriate. During follow-up, 37% of all patients discontinued biological treatment, 17% specifically because of failure. Time-to-failure of treatment was significantly different among patients on an appropriate biological treatment compared to those for whom the treatment was considered not appropriate (p=0.0007). Discontinuation rate after 2years was 26% compared to 54% between those two groups. Patients on inappropriate biological treatment were more likely to have severe disease, concomitant steroids and/or immunomodulators. They were also consistently more likely to suffer a failure of efficacy and to stop therapy during follow-up. CONCLUSION Appropriateness of first-line anti-TNFα therapy results in a greater likelihood of continuing with the therapy. In situations where biological treatment is uncertain or inappropriate, physicians should consider other options instead of prescribing anti-TNFα agents.

The results of the NHTSA survey: for an evaluation of the adequacy and appropriateness of the NHTSA Uniform Highway Safety Standards.

National Highway Traffic Safety Administration, Washington, D.C.

Federal procurement metrication, appropriateness and methods : (final report) /

Mode of access: Internet.

The appropriateness and use of focus group methodology across international mental health communities

The ability to interpret collected data across international mental health communities often proves to be difficult. The following paper reports on the use and appropriateness of focus group methodology in helping to Clarify issues that could help substantiate data collection and comparison across different cultures and regions. Field tests of the focus group methodology were undertaken in different regions and this paper describes an overview of the final field test in Sofia, Bulgaria. The findings and experiences with utilizing this methodology were incorporated in subsequent data collections.

An examination of the appropriateness of the contemporary strategic management models for the Greek small manufacturing enterprises

The starting point of the project was the observation that strategic management is absent in small businesses. The first objective of the project was to examine the reasons causing this situation in Greece, the second one, to examine the appropriateness of the contemporary models of strategic planning for the Greek S.M.E.s, and the third to examine the appropriateness of the alternative approaches to strategic management for the Greek S.M.E.s. The term appropriateness includes (a) the ability of managers to use the models and (b) the ability of the models to assist the managers. The results of the research indicate that none of the two above conditions exists, hence, it is suggested that the contemporary models of strategic management are inappropriate for the Greek S.M.E.s. Many previous research projects on the topic suggest that since the strategic decision making process in S.M.E.s is informal, the whole process is absent or ineffective. Current trends in S.M.E.s' strategic management do not consider the informality of the strategic decision making process as a kind of managerial illness, but as a managerial characteristic. The use of sophisticated data collection and analytical methods does not indicate successful strategic decisions, but it indicates the method large firms use to manage their strategy. According to the literature review, the S.M.E.s' managers avoid the use of the contemporary models of strategic management, because they do not have the knowledge, the resources or the time. Another thesis, expressed by some firms' specialists, suggests that small firms are different from large ones, hence their practice of strategic management should not follow the large firm's prototypes.

Evaluating the appropriateness of speech input in marine applications : a field evaluation

This paper discusses the first of three studies which collectively represent a convergence of two ongoing research agendas: (1) the empirically-based comparison of the effects of evaluation environment on mobile usability evaluation results; and (2) the effect of environment - in this case lobster fishing boats - on achievable speech-recognition accuracy. We describe, in detail, our study and outline our results to date based on preliminary analysis. Broadly speaking, the potential for effective use of speech for data collection and vessel control looks very promising - surprisingly so! We outline our ongoing analysis and further work.

Rethinking policy options for industry:Appropriateness of policies for industry and UK farming and food

Purpose - Studies the implementation of lean supply and partnership relationships in the UK food and farming industry to assess if these types of interventions are effective. Design/methodology/approach - Reviews the challenges affecting the UK supply chain for red meat. Describes the initiatives that were set up to develop a lean supply chain management approach and examines their application in the UK pig and beef industries. Assesses if these changes benefited all participants in the supply chains. Uses semi-structured interviews with key actors in each stage of the supply chain to do this, identifying the power relations within the supply chains and how these affected the outcomes for those participating in the chain. Findings - Concludes that lean initiatives were appropriate for the pig industry but were of limited value for the beef industry. Even within the pig industry, highlights that benefits were not shared equally, with producers, in particular, losing out. Lastly, points out that lean supply chain management is unlikely to be appropriate operationally and commercially in all circumstances in one industry. Argues for a differentiated policy approach and sets out a framework which enables decision makers to select industrial policy options. Research limitations/ implications - Describes the analysis and the framework developed from it. Originality/value - Assesses the effectiveness of lean supply chain management.

Is the French model giving way to a new 'Logic of Appropriateness'? Lessons from urban waste management

Processes of European integration and growing consumer scrutiny of public services have served to place the spotlight on the traditional French model of public/private interaction in the urban services domain. This article discusses recent debates within France of the institutionalised approach to local public/private partnership, and presents case study evidence from three urban agglomerations of a possible divergence from this approach. Drawing on the work of French academic, Dominique Lorrain, whose historical institutionalist accounts of the French model are perhaps the most comprehensive and best known, the article develops two hypotheses of institutional change, one from the historical institutionalist perspective of institutional stability and persistence, and the other from an explicitly sociological perspective, which emphasises the legitimating benefits of following appropriate rules of conduct. It argues that further studying the French model as an institution offers valuable empirical insight into processes of institutional change and persistence. © 2004 Taylor & Francis Ltd.

Evaluating the appropriateness of speech input in marine applications:a field evaluation

This paper discusses the first of three studies which collectively represent a convergence of two ongoing research agendas: (1) the empirically-based comparison of the effects of evaluation environment on mobile usability evaluation results; and (2) the effect of environment - in this case lobster fishing boats - on achievable speech-recognition accuracy. We describe, in detail, our study and outline our results to date based on preliminary analysis. Broadly speaking, the potential for effective use of speech for data collection and vessel control looks very promising - surprisingly so! We outline our ongoing analysis and further work.

The usefulness and appropriateness of a federalist perspective as a theoretical construct for the study of government and civics at the secondary level

This dissertation is the formulation of an argument for the incorporation of a liberated federalism perspective as the foundational theoretical construct for the teaching and study of American government and civics at the secondary level. The argument asserts that the history of the nation, in terms of its basic view of government, has developed from a traditional federalist view to a natural rights view. Instruction of government and politics has paralleled that development. The argument further asserts that the current dependence on the natural rights perspective has contributed and helped legitimize, however unintentionally, the excessive levels of individualism, self-absorption, and uncivil behavior that is being experienced in our society today.^ The argumentation follows the dialectic form presented by Hegel of thesis, antithesis, and synthesis. That is, the thesis argues that the traditional federalist perspective would serve as a viable construct for the teaching of government and civics. In this portion of the argument, the republican model of political reality is presented. The antithesis promotes the natural rights perspective and relies on the political systems model for its theoretical approach. Finally, the synthesis argues that a liberated federalism perspective should be the foundational construct. Here, the argument presents its own model as a theoretical construct that is designed to assist teachers and curriculum materials writers in the development of American government and civics lessons and materials. ^

Evaluating the Appropriateness of Project Delivery Systems for Different Trenchless Methods

Trenchless methods have been considered to be a viable solution for pipeline projects in urban areas. Their applicability in pipeline projects is expected to increase with the rapid advancements in technology and emerging concerns regarding social costs related to trenching methods. Selecting appropriate project delivery system (PDS) is a key to the success of trenchless projects. To ensure success of the project, the selected project delivery should be tailored to trenchless project specific characteristics and owner needs, since the effectiveness of project delivery systems differs based on different project characteristics and owners requirements. Since different trenchless methods have specific characteristics such rate of installation, lengths of installation, and accuracy, the same project delivery systems may not be equally effective for different methods. The intent of this paper is to evaluate the appropriateness of different PDS for different trenchless methods. PDS are examined through a structured decision-making process called Fuzzy Delivery System Selection Model (FDSSM). The process of incorporating the impacts of: (a) the characteristics of trenchless projects and (b) owners’ needs in the FDSSM is performed by collecting data using questionnaires deployed to professionals involved in the trenchless industry in order to determine the importance of delivery systems selection attributes for different trenchless methods, and then analyzing this data. The sensitivity of PDS rankings with respect to trenchless methods is considered in order to evaluate whether similar project delivery systems are equally effective in different trenchless methods. The effectiveness of PDS with respect to attributes is defined as follows: a project delivery system is most effective with respect to an attribute (e.g., ability to control growth in costs ) if there is no project delivery system that is more effective than that PDS. The results of this study may assist trenchless project owners to select the appropriate PDS for the trenchless method selected.